The pattern changes could mean that efforts to improve perinatal care and reduce the number of non-medically necessary c-sections may be working. Some hospitals have gone as far as disallowing elective delivery prior to 39 weeks.

The overall rate of c-sections has stopped rising for two years after steadily increasing for more than a decade. The rate of c-sections was 33 percent in 2011, the latest data available.

Studies have linked c-sections to higher rates of postpartum depression, and doctors say the surgery can lead to complications that include hemorrhaging and infections. It also takes the mothers longer to recover.

The push for fewer c-sections came after doctors found that mothers were demanding more frequently to have labor induced, which makes them twice as likely to have a C-section. Some doctors also feared malpractice lawsuits and may have turned to cesareans more.

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